Provider Demographics
NPI:1881482537
Name:PATTERSON, CAMARSHAY
Entity type:Individual
Prefix:
First Name:CAMARSHAY
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 CROSSPOINT BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3386
Mailing Address - Country:US
Mailing Address - Phone:317-238-3168
Mailing Address - Fax:919-928-5528
Practice Address - Street 1:792 WHITE ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1445
Practice Address - Country:US
Practice Address - Phone:317-238-3168
Practice Address - Fax:919-928-5528
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician